Asthma and sickle cell disease (SCD) are two chronic conditions associated with increased pediatric mortality, morbidity and health care utilization in the United States. The University of California, San Francisco (UCSF), in partnership with the Vermont Child Health Improvement Program (VCHIP), the Pacific Sickle Cell Regional Collaborative (PSCRC) and the California Health Institute has created the ?IMPLEmenting MEasures NeTwork (IMPLEMENT) for Child Health Network?. The IMPLEMENT Network will evaluate, in 10 different states, two sets of quality measures recently developed by the Pediatric Quality Measures Program (PQMP) in asthma and SCD. The overarching goal of this project is to rigorously evaluate and refine these PQMP measures so that they can be appropriately applied by practitioners, administrators and purchasers to improve health care quality.
Our Specific Aims are (Aim 1) to assess the feasibility of implementing the PQMP measures within the Medicaid patient populations. We will partner with Medicaid or state agencies in 4 states (CA, OR, VT, MA). Feasibility will be based on the measurement burden in implementing the PQMP quality measures and whether significant differences can be measured at the state, health plan or provider level.
(Aim 2) We will assess the usability of the PQMP measures in driving and defining quality improvement (QI) goals for asthma (in CA, VT) and for SCD through the Pacific Sickle Cell Regional Collaborative (in CA, OR, NV, AZ, WA, AK, ID,HI). We will use the PQMP measures in pediatric QI collaboratives in a variety of settings. We will define usability as the ability of the PQMP quality measures to (i) help create and identify feasible strategies for improvement; to (ii) help evaluate overall improvement during plan-do-study-act (PDSA) cycles; and to (iii) be responsive to QI initiatives.
(Aim 3), Based on work from Aims 1 and 2, we will promote the dissemination of the PQMP measures by submitting the quality measures that meet endorsement criteria to the National Quality Forum (NQF). To ensure that we have a broad perspective in our evaluation, we have recruited multidisciplinary Advisory Cores that include experts from professional organizations (American Board of Pediatrics), family advocacy groups, QI networks, Medicaid agencies and Accountable Care Organizations. In addition to knowledge about the feasibility and usability of PQMP measures, the IMPLEMENT Network anticipates making several work products publicly available for dissemination as appropriate, which will facilitate the use of the measures submitted. This includes measure ICD10 codes, programming (data preparation and analysis), abstraction tools and updated technical specifications. The completion of the aims listed above by the IMPLEMENT Network will lead to important improvements that can potentially improve pediatric care and outcomes for all children. These measures will help improve the quality of care for pediatric asthma and sickle cell disease, as well as help administrators, payors and consumers identify higher value care, which will lead to a healthier population.
We will test and use new pediatric quality measures for sickle cell disease and asthma. By understanding how to refine and apply these measures, we can potentially improve pediatric care and outcomes for children with asthma and sickle cell disease.